Du Xu-Dong, Zhu Ping, Li Mi-Er, Wang Ju, Meng Hong-Dao, Zhu Cai-Rong
Department of Epidemiology and Health Statistics,West China School of Public Health,Sichuan University,Chengdu 610041,China.
University of South Florida,College of Behavioral & Community Sciences,School of Aging Studies, Tampa 33620,United States.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2018 Mar;49(2):252-257.
To compare EQ-5D and SF-6D for measuring health utility of stroke patients in health economic evaluation studies.
A prospective cohort study was conducted on 596 stroke patients in the West China Hospital of Sichuan University from 2010 to 2016. Data were collected at baseline through face to face interviews and at the follow-up stages through telephone interviews with a three-month interval. EQ-5D and SF-6D were used for measuring health utility scores of the participants. The consistency of the two instruments was assessed using Bland-Altman plot and Intraclass correlation coefficient () . Logistic regression models were established to identify predictors of health utility.
The participants had a mean utility score of 0.78 (95% confidence interval:0.76, 0.80) in EQ-5D,compared with 0.74 (95% confidence interval: 0.73, 0.76) in SF-6D,and a median (interquartile range) of 0.86 (0.68, 1.00) in EQ-5D and 0.73 (0.62, 0.86) in SF-6D. The 95% limits of agreement between the two instruments ranged from -0.28 to 0.35,with an of 0.67 (95% confidence interval: 0.62,0.71). EQ-5D had a higher ceiling effect. The health utility score of stroke patients changed there rapidly in acute phase (less than 3 months) but barely changed there after.Severity of stroke was a major predictor of health utility scores.
The two instruments generate inconsistent results in health utility. SF-6D is better for measuring health utility in patients with stroke in China.
在健康经济评估研究中比较EQ-5D和SF-6D用于测量中风患者的健康效用。
对2010年至2016年四川大学华西医院的596例中风患者进行了一项前瞻性队列研究。在基线时通过面对面访谈收集数据，在随访阶段通过每隔三个月的电话访谈收集数据。使用EQ-5D和SF-6D测量参与者的健康效用得分。使用Bland-Altman图和组内相关系数评估这两种工具的一致性。建立逻辑回归模型以确定健康效用的预测因素。
EQ-5D中参与者的平均效用得分为0.78（95%置信区间：0.76，0.80），而SF-6D中为0.74（95%置信区间：0.73，0.76），EQ-5D的中位数（四分位间距）为0.86（0.68，1.00），SF-6D为0.73（0.62,0.86）。两种工具之间的95%一致性界限为-0.28至0.35，组内相关系数为0.67（95%置信区间：0.62,0.71）。EQ-5D有更高的天花板效应。中风患者的健康效用得分在急性期（少于3个月）变化迅速，但之后几乎没有变化。中风严重程度是健康效用得分的主要预测因素
这两种工具在健康效用方面产生不一致的结果。在中国SF-6D更适合测量中风患者的健康效用。
